Ketner, Mark & Kelli 90044C

��°"`°""❑CAMA ❑DREDGE & FILL N9 90044 A B C D
3 GENERAL PERMIT Previous permit
Date previous permit issued
bf�ew ❑Modification ❑Complete Reissue ❑Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
ISA NCAC ' t)l� ❑ Rules attached.. General Permit Rules available at the following link: www.deq.ncgov/CAMArules
Applicant Name Authorized Agent .1-1 of-" `y
T
Address - Project Location (County): *-Cvt.-.tl-�.k'
t
City State ZIP Street Address/State Road/Lot #(s)
Phone #
Email
Subdivision
City
Affected ❑y' CW ❑ EW ❑ PTA ❑ ES ❑ PITS Adj. Wtr. Body - (nar/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wen Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Shoreline Length
Access Length _llilgJ ,k L' - 'C'. j .Hi i ..
Pier (dock) length . ' X > vi
Fixed Platform(s) G k ? L)-
-III4 T
Floating Platform(s) � "' i tl ,_r � r„ � � � 1- •t«(-q __
Finger pier(s) ,,.�" ( 810
Total Platform area j (rr�) �j }`
Groin length/ft 1_ _ _ _ 1 `i +_ \
Bulkhead/Riprap length-
Avgdistanceoffshore
----
Breakwater/Sill
Max distance/ length ---
Basin, channel t -4) — - -- —
Cubic yards
Boat ramp
Boathouse/ Boatlift ) -
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions -
(Scale: )
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM4W65E.OF S�,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Pleaselnitial) II
Permit Officer's PRINTED Name
Signatufe T-Please reed compliance statement on back of permit' Signature
Application Feels) Check k/Money Order Issuing Date Expiration Date

(III
©CAMA ElDREDGE & FILL N9 90044 A B C. D
GENERAL PERMIT Previous permit
Date previous permit issued -
pNew ❑Modification ❑Complete Reissue ❑Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC ❑ Rules attached. Y General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name k.k: I `..( Ci
Address �,-,.;T.• -\� ,,C,
Cityi s State N i/.. zip 1 ` , l") 0
Phone#O
Email f. ( 4 VA ! Eii. C4 rVlA I
Affected UdCW ❑EW PTA ❑ES ❑PTS
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Shoreline Length
Access Length
Pier (dock) length Li.
Fixed Platform(s)
Floating Platform(s)
Finger pler(s)
Total Platform area 4.
Groin length/ri
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing !
Other
SAV observed: yes no ! _I
Moratorium: n/a yes no rl
Site Photos: yes no
Riparian Waiver Attached: '- yes no
A building permit/zoning permit may be required
Permit Conditions
Authorized Agent j. r )`t - /
Project Location (County): CCi.+_--':��.E-•
Street Address/State Road/Lot #(s) .:+1 t"' {_....
Subdivision '-
City %A14, ZIP
r
Adj. Wtr. Bodyi '• A,. f J 6 t/man/unk)
Closest Maj. Wtr. Body 1k �,1 -�-f. r.' C/'
J
(Scale:/JT j
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Pleaselnitial) _
i�
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature**Please read compliance statement on back of permit" Signature
Application Feels) Check p/Money Order Issuing Date Expiration Date

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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: r " a yk— V?.l.0 V=,L�n
Mailing Address: I-7I 5b&j, �- Oi6A B_
Phone Number: 01 to,- ego - I `fz
Email Address: V-C& f nPyTQn_ 0i'Vai'.f.l l (OYf'�
I certify that I have authorized I11-
Agent Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at
in 001 Y)aaCounty.
t furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
Title
Date
This certification is valid through I
JAN 2 52612;
1XPifi-MHL; OTY

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner:
Address of Property:
Mailing Address of Owner: �(lrhK /��yyyy�� ((�� p 7� �(
22 Owner's email: � . Owner's Phone#: -L b' 'CJ� 1
Agent's Name: C�. Agent Phone#: ,;?.
Agent's Email.
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
I hereby certify that I own property adjacent to the above referenced property. The individual applying for this
permit has described to me, as shown on the attached drawing, the development they are proposing. A
description or drawing with dimensions must be provided with this letter.
2_ 1 DO NOT have objections to this proposal. I DO have objections to this proposal.
If you have objections to what is being proposed, you must notify the N.C. Division of Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 400 Commerce Ave., Morehead City, NC 28557. DCM representatives can also be contacted
at [phone]. No response is considered the same as no objection if you have been notified by
Certified Mail.
WAIVER SECTION
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or
groin must be set back a minimum distance of 15' from my area of riparian access unless waived by me
(this does not apply to bulkheads or riprap revetments). (If you wish to waive the setback, you must sign
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback t /
Signature ofAdjacent Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
Mailing Address of ARPO:
ARPO'semail: Trh✓;vicez �ARPO'sPhone#:=.2i�-�.��-,Gle
�
Date: lZ- s"- *waiver is valid for up to one year from ARPO's Signature*
Revised May 02 f1369 IZ
JANI 25 20r,
YJ(:i1H-M,"16 (111TY

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: P76, /L C
Address of Property:
Mailing Address of Owner:
Owner's email:y� f1�'tt wner's Phone#: % I`7 49.) -142 j/
Agent's Name://� I dL t/ �O Agent Phone#:�- 31 `f S3 �'
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent Property Owner)
I hereby certify that I own property adjacent to the above referenced property. The individual applying for this
permit has described to me, as shown on the attached drawing, the development they are proposing. A
description or drawing with dimensions must be provided with this letter.
I DO NOT have objections to this proposal. I DO have objections to this proposal.
If you have objections to what is being proposed, you must notify the N.C. Division of Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 400 Commerce Ave., Morehead City, NC 28557. DCM representatives can also be contacted
at [phone]. No response is considered the same as no objection if you have been notified by
Certified Mail.
WAIVER SECTION
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or
groin must be set back a minimum distance of 15' from my area of riparian access unless waived by me
(this does not apply to bulkheads or nprap revetments). (If you wish to waive the setback, you //must sign
the appropriate blank below.) // i e�� �S' C d�eu-�`�"` • 7
I DO wish to waive someiall of the 15' setback T°
Signat /scent Riparian rope caner
-0 R-
I do not wish to waive the 15' setback requirement (initial Pe blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
Mailing Address of ARPO: lit SAt"r+s��
ARPO's email:,g/ 4/, , e, ARPO's Phone#: 3 L ( '&k)
Date: /- Z 5'' Z 3 *waiver is valid for up to one year from ARPO's Signature*
Td!1ir'_t,
Revised May 2�21

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Property Info
Building Info
PARCEL NUMBER:
OWNER:
PHYSICAL ADDRESS
MAILINGADDRESS:
LEGAL DESCRIPTION:
DEED REF:
PLAT REFERENCE:
NEIGHBORHOOD:
SALE DATE:
SALE PRICE:
ACREAGE:
LAND VALUE:
BUILDING VALUE:
EXTRA FEATURE VALUE:
PARCELVALUE:
Sketches
Nc 1,aclesAYaladc
Photos
ETUX KELLI
,URES POIN DR
ENSF-, D O'Ai C`
RI 2752
3 =LTr SHORES E', ;;„=_
BATH S:
BEDROOMS:
CONDITION:
EXTERIOR WALLS:
FLOOR FINISH:
FOUNDATION:
HEAT:
ROOF COVER:
ROOF STRUCTURE:
TOTAL SQUARE FOOTA
HEATED SQUAREF001
YEAR BUILT:
J A N 2 5 20;'
DQui-mmu t.;I I y

GE:
AGE:
1�
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